Healthcare Provider Details

I. General information

NPI: 1922755883
Provider Name (Legal Business Name): MAKINI MEDICAL TRANSPORTATION AND LOGISTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 MARIETTA WAY
DURHAM NC
27703-6786
US

IV. Provider business mailing address

215 MARIETTA WAY
DURHAM NC
27703-6786
US

V. Phone/Fax

Practice location:
  • Phone: 919-695-3518
  • Fax:
Mailing address:
  • Phone: 919-695-3518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: PATRICIA CHERIE MCNEILL
Title or Position: OWNER
Credential:
Phone: 919-695-3518